Columbia University proposes to continue its NLM-supported training program in biomedical informatics, initiated in 1992, expanded in 1997, and renewed in 2002. Our goal is to help to shape the evolving discipline of biomedical informatics by defining a rigorous, academically-oriented training program that offers complementary exposures to real-world systems, both in clinical settings here at CUMC/NYPH and in the biological sciences through the Columbia Center for Computational Biology and Bioinformatics. Our training program seeks to further the development of the field, and the quality of future research, by demonstrating to its students, and to the biomedical community, that biomedical informatics addresses fundamental issues of biomedical knowledge and information, their representation, and their biomedical application. We have accordingly developed and evolved a curriculum that assures that our graduates will be familiar with a broad range of pertinent topics in the field. Each trainee then selects an area of subspecialization within the field, with the established tracks being clinical informatics, public health informatics, imaging informatics, or bioinformatics. Our degrees generally require a minimum of two years for the MA and four years for the Ph.D, although most students take somewhat longer. We are proposing to enroll 10 NLM-suported predoctoral trainees and 8 NLM-supported postdoctoral trainees per year (with 1 additional predoc and 2 additional postdocs in Years 1 and 2 due to a supplement we have already received for Public Health Informatics training). We expect over 50 graduate students and post-doctoral trainees in our entire (NLM and non-NLM) program in September 2006. Among our 103 graduates since approval of our degree program, we have graduated 16 PhD students, 7 of whom were NLM-supported. We have had 87 graduates of our masters program, 27 of whom were NLM-supported post-doctoral trainees. Eleven non-degree NLM postdoctoral trainees have also completed training with us since 1994. We have a large, internationally recognized faculty with consistent involvement in national biomedical informatics projects. Education for our trainees involves one-on-one experience with faculty members, working on research projects that in many cases are conceived by the students themselves. Almost all trainees are formal degree candidates and take coursework from within the Department and from the excellent resources available at Columbia University. The faculty, research staff, and students form a critical mass for providing a provocative environment for the seminars, journal clubs, and discussions. Our clinical information systems service responsibilities offer trainees opportunities to get first-hand exposure to, and training on, state-of-the-art clinical, educational, administrative, and research information systems.